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Feet: Toe Fracture

I broke two toes rock climbing a few months back and they have yet to heal. One is looking OK, but the other still has no mobility at the joint closest to the foot. Bending it is painful. Should I get it checked out or be more patient?

I am 31 years old and vegetarian. Not sure if this matters, but my bones seem reluctant to heal based on another break last year. I've been dosing with calcium and vitamin D as well as doubling the dark leafies.

CHRIS VULTAGGIO

Rock and Ice Forum

One of my good friends, a dentist, sidled up to me at the gym. He was only wearing one shoe.

"Can you have a look at my toe?" he asked. "I don't think it is broken but, gee, it hurts."

He'd stubbed it on the side of a windsurfer. Being both observant and practical, he proceeded to straighten it and continued surfing for a few hours. Then it was off to the gym where he squeezed it into a shoe for several more hours.

"It's broken, George!"

"Nooooo! Really?" he asked, looking astonished. The following day he put his foot in the dental x-ray machine and delivered some postage-stamp films.

Shattered is probably a more accurate description of the condition. Were it not his little toe he probably would have needed surgery to screw it back together.

Toe fractures can be rather messy, and surgery is not out of the question. Smash one badly enough and you will end up with a fused joint. Or worse, it may just piss you off for the rest of your life. But, hey, it's just your toe, right?

I would spend some bucks on an x-ray just to see what you are dealing with. If all is well, do as the Greeks did -- roll over, bite your pillow and have that appendage manipulated. It'll be worth it in the morning.

A vegetarian diet is fine if you manage it well. Simply deleting meat from your diet is a little remiss. A deficiency in protein, and its compatriots iron and zinc, will certainly slow fracture healing.

Collect a variety of vegetables. Make a rainbow installation in your shopping cart and you should be halfway there. Nuts and fish (one of the few vegetables to have bones) are great sources of minerals. That said, it's a complex issue, and I'm not a nutritionist.

When Voodoo met Hypnotism there was more panting than a pervert at a nudist beach. Sparks flew, knees got grubby, and a bastard child called Marketing was born. Dudes are paid a lot of money to carefully word supplement labels. Unless you live in Lapland or the dark side of the moon, you are unlikely to need vitamin D supplements at your age for healthy bones. There is some hoopla that performance in athletes can be affected by vitamin-D insufficiency, but I would save your pill money and see a nutritionist instead. Supplements are superfluous for most vaguely healthy people, and if your issue was that straightforward they would have worked already.

If the flexibility is not improving and x-rays don't show fractures that are not healing, manual therapy is a good idea. Delayed fracture healing will feel like grating bone ends when you bend your toe. After the grating will come vomiting and passing out.

Plain radiography remains the standard method to monitor fracture healing, but it documents delayed healing only late in the course. See your doctor if pain persists.